abuse

Abuse

Definition

Abuse is defined as any action that intentionally harms or injures another person. Abuse also encompasses inappropriate use of any substance, especially those that alter consciousness (e.g., alcohol, cocaine, methamphetamines).

Description

There are several major types of abuse: physical abuse, sexual abuse, substance abuse, elder abuse, and psychological abuse. All forms of abuse in the United States are illegal and have the potential to carry serious criminal penalties.

Physical abuse

Physical abuse is the infliction of injury by another person. Physical abuse can happen to both children and adults of either gender and of any sexual orientation. The injuries can be inflicted by punching, kicking, biting, burning, beating, or use of a weapon such as a baseball bat or knife. Physical abuse can result in bruises, burns, poisoning, broken bones, and internal hemorrhages.According to the United States Department of Health and Human Services Administration for Children and Families, in 2006 in the United States there were 1,530 child fatalities that resulted from child abuse (a rate of just over 2 deaths per 100,000 children). Of these, about three-quarters of the children were under four years old, with the largest number of deaths occurring in infants under one year old. In addition, about 905,000 children were victims of nonfatal maltreatment (a rate of about 12 children 12 per 1,000 population). Nearly three-quarters of these children were victims of repeated maltreatment. Nearly 83% of abused children were abused by a parent or a parent acting with another individual.Physical abuse of adults primarily occurs against women. The United Nations Development Fund for Women estimates that one-third of all women in the world will be beaten, coerced into sex, or otherwise abused during their lifetime. Sixty-nine percent of women worldwide report that at some time during their life they have been abused by a spouse or man with whom they are intimate. Intimate partners also commit the majority of murders of women. Violence against women tends to increase in times of economic downturns and political or social chaos (e.g., when a country is at war). Domestic violence is also strongly linked to substance abuse among the perpetrators. The U. S. Department of Justice found that in domestic violence cases, 61% of the perpetrators and 36% of the victims had a substance abuse problem. The most common substance abused was alcohol. Males can be victims of physical abuse, especially in homosexual relationships, but the statistics for abuse against men are more poorly documented than for abuse against women and children.

Sexual abuse

Sexual abuse of a child refers to sexual behavior between an adult and child or between two children, one of whom is forcefully dominant or significantly older. Sexual behaviors can include touching breasts, genitals, and buttocks while the victim is either dressed or undressed. Sexual abuse behavior also includes exhibitionism, cunnilingus, fellatio, or penetration of the vagina or anus with sexual organs or objects. Pornographic photography also is a form of sexual abuse of children. The U.S. Department of Justice estimates that one in six victims of a sexual assault are under age 12. Despite publicity surrounding cases where a child is assaulted by a stranger, almost all sexual assaults against children are perpetrated by a family member (e.g. father, stepfather, aunt, uncle, sibling, cousin) or family intimate (e.g., a live-in lover or friend of the parent).Sexual abuse also can take the form of rape. The legal definition of rape includes only slight penile penetration in the victim's outer vulva area. Complete erection and ejaculation are not necessary. Rape is the perpetration of an act of sexual intercourse when:

will is overcome by force or fear (from threats, use of weapons, or use of drugs).

mental impairment renders the victim incapable of rational judgment.

if the victim is below the legal age established for consent.

The National Coalition Against Domestic Violence (NCADV) estimates that 1 in 5 women and 1 in 33 men will be the victim of a rape or an attempted rape during their lifetime. According the U.S. Department of Justice, 54% of all rapes are of women under age 18. Rape can occur within the context of marriage. Marital rape accounts for about 25% of all rapes in the United States. Marital rape is often accompanied by physical and psychological abuse. In 90% of all rapes, the woman knows the rapist. Women who are victims of a sexual assault have a high chance of experiencing depression, posttraumatic stress disorder, developing substance abuse, and of becoming suicidal

Substance abuse

Substance abuse is an abnormal pattern of substance usage leading to significant distress or impairment. Alcohol, street drugs, and prescription drugs are common substances of abuse. Substance abuse is often a contributing factor in physical and sexual abuse. Children of parents who are substance abusers are more likely to experience abuse than children living in households where there is no substance abuse. The National Committee to Prevent Child Abuse found that in the united States, 80% of child abuse cases were associated with substance abuse by the perpetrator.The criteria for substance abuse is one or more of the following occurring within a 12-month period:

recurrent substance use resulting in failure to fulfill obligations at home, work, or school.

using substance in situations that are physically dangerous (i.e., while driving or operating machinery).

recurrent substance-related legal problems.

continued usage despite recurrent social and interpersonal problems (i.e., arguments and fights with significant other).

Elder abuse

Abuse of the elderly is common and occurs mostly because of caregiver burnout due to the high level of dependency and continuous care that frail, elderly individuals often require. The NCADV estimates that in 2007 there were 2.1 mission cases of elder abuse in the united States but that only 1 out of every 14 cases was reported to authorities. Victims tend to be over age 50 and highly dependent on their caregivers because of physical or mental disabilities. In 90% of the cases, the abuser is a family member.Elder abuse can take the form of physical abuse, psychological abuse, sexual abuse, or financial abuse. Examples of elder abuse include:

withholding food, water, or medicines

delaying needed medical care

coercing or deceiving an elderly person into signing legal documents

wrongful use of the elderly individual's money

removing or selling the elderly individual's property without permission

Psychological abuse

Victims of psychological abuse can be of any age or gender. This form of abuse is often difficult to prove. It includes threatening the victim with violence, harassing them when the are outside the home (e.g., at school or work), denying the victim access to others (e.g., refusing to allow the victim to see friends, preventing use of the telephone), confining the victim to home, or destroying the victim's property. A woman with a physical disability has a greatly increased likelihood of being psychologically abused. Men who are unemployed but living in a household where the woman works are most likely to be psychological abusers. Almost all men who physically abuse women also psychologically abuse them.

Causes and symptoms

Children who have been abused usually exhibit a variety of symptoms that encompass behavioral, emotional, and psychosomatic problems (body problems caused by emotional or psychological disturbance). Children who have been physically abused tend to be more aggressive, angry, hostile, depressed, and have low self-esteem. Additionally, they exhibit fear, anxiety, and nightmares. Severe psychological problems may result in suicidal behavior or posttraumatic stress disorder. Physically abused children may complain of physical illness even in the absence of a cause. They also may develop eating disorders or encopresis. Children who are sexually abused may exhibit abnormal sexual behavior in the form of aggressiveness and hyperarousal. Adolescents may display promiscuity, sexual acting out, and homosexual exploration. Children who are psychologically abused or who witness psychological abuse are more likely to become psychological abusers as adults.Physical abuse directed towards adults can ultimately lead to death. Approximately 50% of women murdered in the United States were killed by a former or current male partner. Approximately one-third of emergency room visits by women are prompted by an incident of domestic violence. Female victims who are assaulted by an intimate partner also have a higher rate of internal injuries and loss of consciousness than victims of stranger assault (e.g., mugging, robbery). As well as showing physical signs of abuse, adults who are abused often have poor health, difficulty concentrating, suicidal thoughts, clinical depression, low self-esteem, and a high rate of substance abuse. Many victims of abuse are afraid or unwilling to admit the abuse is occurring and will go to great lengths to disguise their situation.

Diagnosis

Physical abuse should be suspected whenever children or adults have unexplained injuries, especially when these injuries occur with an unexpectedly high frequency. A report may be filed with the local family social services agency that will initiate investigations. A police report may also be made. The authorities normally will follow up the allegation of abuse.Sexual abuse of both a child and an adult may be identified from information given by the victim. Victims can be assessed for signs of ejaculatory evidence from the perpetrator. Ejaculatory specimens can be retrieved from the mouth, rectum, and clothing. Tests for sexually transmitted diseases may be performed.Elder abuse should be suspected if a dependent individual demonstrates a fear of the caregiver. Additionally, elder abuse can be suspected if there are signs indicating intentional delay of required medical care, an unexpected change in medical status, or a significant change in the elderly individual's financial status.Substance abuse usually causes behavioral changes such as failure to perform expected tasks or inability to meet reasonable work and family responsibilities. It should be suspected in a person who continues to use their drug of choice despite recurrent negative consequences. The diagnosis can be made after administration of a comprehensive physical exam and a chemical abuse assessment by a therapist.

Treatment

Both children and adults who are victims of physical or sexual abuse typically require immediate medical attention and long-term psychotherapy. Many victims of abuse, especially children who are sexually abused, take years to come to terms with the abuse. Therapists who specialize in treating victims of physical and sexual abuse can help the individual understand has happened and suggest ways to make positive steps toward moving past the abuse. Support groups can be helpful for some victims. When children are abused by the adults they live with, they may be removed from the abuser's home and placed in foster care or a group home. Psychological counseling and anger management should also be made available to the abuser. The effects of all types of abuse can last for years even with good mental health care. Children witnessing abuse, even if they were not abused themselves, also are often adversely affected and can benefit from psychotherapy.Substance abusers may elect treatment or be sent to a treatment facility as part of a law enforcement proceeding. Treatment for substance abusers can be at either an inpatient or outpatient facility, depending on severity of addiction. Psychological counseling, behavior modification strategies, and medications may be to assist in abstinence. The individual should be encouraged to participate in community-centered support groups (e.g., Alcoholics Anonymous, Narcotics Anonymous). Support groups also exist for family members of substance abusers.Toll-free telephone hotlines available 24 hours a day, 7 days a week can provide referrals and counseling for people in an abuse crisis situation. People calling these hotlines may choose to remain anonymous. A list of national hotlines in the United States can be found in the reference section of this article.

Prognosis

How an individual progresses after experiencing an abuse situation depends on the individual's personality, the type of abuse, the length of time the individual was abused, family support, and the professional support services available. Usually victims of abuse require extensive psychotherapy to deal with emotional distress associated with the incident. Perpetrators require further psychological evaluation and treatment. Victims of abuse may have a variety of emotional problems including depression, acts of suicide, post-traumatic stress disorder, and anxiety disorder. Many turn to substance abuse as a way to avoid dealing with their emotions. Children who experience sexual abuse may enter abusive relationships or have problems with intimacy as adults. Substance abusers may experience relapses since the cardinal feature of all addictive disorders is a tendency to return to symptoms. Elderly individuals may suffer from further medical problems and/or anxiety; in some cases neglect may precipitate death.

Prevention

Prevention programs are geared to education and awareness. Detection of initial symptoms or characteristic behaviors may assist in identifying some potential abuse situations. Certain professionals in the United States are required by law to report suspected child abuse. These include teachers, social workers, law officers, and some medical personnel. In some cases treatment may be sought before incident. The professional treating the abused persons must develop a clear sense of the relationship dynamics and the chances for continued harm.

Key Terms

Encopresis

Abnormalities relating to bowel movements that can occur as a result of stress or fear.

For Your Information

Resources

American Help Hotlines

Childhelp National Child Abuse Hotline 1-800-4-A-CHILD. TDD for the Deaf 1-800-2-A-Child. Help for children who are being abused or adults who are concerned that a child they know is being abused or neglected.

abuse

domestic abuse abuse of a person by another person with whom the victim is living, has lived, or with whom a significant relationship exists. The abuse may take the form of verbal abuse, sexual abuse, physical battering, or psychological (emotional) unavailability. Abuse is a learned behavior and has an escalating cycle; abusive behavior cuts across all racial, ethnic, educational, and socioeconomic boundaries.

drug abuse see drug abuse.

elder abuse maltreatment of an older adult, ranging from passive neglect of needs to overt mental, physical, or sexual assault.

physical abuse any act resulting in a nonaccidental physical injury, including not only intentional assault but also the results of unreasonable punishment.

sexual abuse any act of a sexual nature performed in a criminal manner, as with a child or with a nonconsenting adult, including rape, incest, oral copulation, and penetration of genital or anal opening with a foreign object. The term also includes lewd or lascivious acts with a child; any sexual act that could be expected to trouble or offend another person when done by someone motivated by sexual interest; acts related to sexual exploitation, such as those related to pornography, prostitution involving minors, or coercion of minors to perform obscene acts.

substance abuse a substance use disorder characterized by the use of a mood or behavior-altering substance in a maladaptive pattern resulting in significant impairment or distress, such as failure to fulfill social or occupational obligations or recurrent use in situations in which it is physically dangerous to do so or which end in legal problems, but without fulfilling the criteria for substance dependence. Specific disorders are named for their etiology, such as alcohol abuse and anabolic steroid abuse. DSM-IV includes specific abuse disorders for alcohol, amphetamines or similar substances, cannabis, cocaine, hallucinogens, inhalants, opioids, PCP or similar substances, and sedatives, hypnotics, or anxiolytics. See also drug abuse.

a·buse

(ă-byūs'),

1. Misuse or wrongful use, especially excessive use, of anything.

2. Injurious, harmful, or offensive treatment, as in child abuse or sexual abuse

Abuse

The violation of one’s human and civil rights, or action or deliberate inaction that results in neglect and/or physical, sexual, emotional or financial harm. Abuse can be perpetrated by one or more people (either known or not known to the victim) or can take the form of institutional abuse within an organisation; it can be a single or a repeated act. Drugs See Misuse

abuse,

n the misuse of legal or illegal substances with the intent to alter the user's feelings, behavior, or perception.

abuse, elder,

n the behavior or treatment toward an elderly person, by another person in a position of care, that has the purpose or effect of harming the elderly person's well-being. Such harm may include economic, physical, sexual, or mental abuse.

abuse, nitrous oxide,

n the deliberate inhalation of nitrous oxide to produce mood-altering effects. A type of substance abuse.

abuse, polysubstance,

n the physical dependence on at least three substances that have been classified as habit forming, but without any one of the substances having greater importance or influence than the others. The concept does not include caffeine or nicotine.

abuse, sexual,

n sexual acts performed with children or with nonconsenting adults in a criminal manner.

abuse, substance,

n the misuse of legal or illegal substances with the intent to alter some aspect of the user's experience. May include medications, illicit drugs, legal substances with potential mood-altering effects (such as alcohol or tobacco), or substances whose primary use may not be for human consumption (such as inhalants).

abuse

misuse, maltreatment or excessive use.

animal abuse

a modern day concept by which the trust that animals should have in humans, in return for the benefits that they bestow, is betrayed when humans abuse animals physically or psychologically. The abuses often stop short of cruelty in a legal sense but can be classified as harassment. The term has a variable but generally wide scope and includes physical cruelty by assault, by deprivation of adequate food, water, transport and shelter, and proper care during illness, pregnancy and parturition, and participation in sporting events at a level beyond the animal's capacity to perform. This form of abuse covers such misuses as riding horses in rodeos, excessively arduous endurance rides, ignominious performances and exhibits, oppressive displays of obedience. Mental or psychological abuse is less readily defined but in today's culture is usually taken to include undue confinement, demeaning performance as entertainment and harassment by teasing.

Patient discussion about abuse

Q. what is a sentimental abuse? in what ways does it show? i think my boyfriend is abusing me and playing with my emotions , does it call "Sentimental Abuse" , who do i need to see to get over it ?

A. In any situation any kind of abuse is wrong... If he is playing with your emotions sometimes it is good to see a councellor or someone you can talk to to get your feelings out in the open, sometimes it works sometimes it don't.... I just got out of an abusive relationship although it was not my emotions he was playing with it still helped to seek out someone that will listen maybe give suggestions on how you can either get out or fix the problem.

Q. What is the difference between alcoholism, alcohol abuse and alcohol dependent?

A. Alcoholism is the high carve for drinking without caring for negative results it will have on physical, mental, emotional and social life. A binge drinker who continues to drink even though the problem has started in his normal life will lead to alcohol abuse and he may start the journey for alcoholism. In alcohol dependence the drinker steps up from the alcohol abuse and the crave increases in spite of the biggest problem on head. We can say that alcohol dependence is alcoholism.

Q. My son who is an alcohol abuse is undergoing treatment? My son who is an alcohol abuse is undergoing treatment. He stops his medicines in the middle of the treatment and restart taking alcohol. Doctor had warned to stop consuming alcohol in excess. With heavy drink he comes late at night and it frightens me. He drinks alcohol very badly and behaves violent also. He says he cannot stop. I am getting worried and was finding some information about the harm effects the excess drinking can bring to him?

A. A) He must stop or reduce alcohol now. Allow him to drink in house so that he can be safe from some other dangerous situations which can mess his life. Once in home you can deal him well. At least you can make him to have his medicines. The adverse effects of alcohol consumption are liver damage, anemia, nerve damage, and pancreatitis. These can ruin his life.

The penalties against senior soldiers that are stipulated in articles 110, 111 and 117 of the Military Criminal Law should be increased and the legal impediments against soldiers reporting on mistreatment should be removed, the declaration of the symposium said.

MANAMA (TAP) - The head of the Public Prosecution's Special Investigation Unit, Nawaf Hamza, announced the investigation of 15 policemen for their alleged involvement in mistreatment of inmates in custody.

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